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Biomedical subjects

A Spurgeon

Publications and source records attributed to A Spurgeon.

17 recordsLinked to original sources
PubMed2001

The Life Events Inventory: re-scaling based on an occupational sample.

The objective of this study was to compare the validity of the original weightings used by the Life Events Inventory (LEI) with those obtained from a contemporary occupational sample. Fifty male and 62 female manufacturing employees (age range 16-55 years) assigned scores to each item on a slightly modified version of the LEI scale. The current sample consistently assigned higher weights to events/items than did the original sample, but there was high agreement in terms of item ranking. Some distinct age and gender differences in scoring were apparent, and are discussed further. It was concluded that when separate weightings are employed for age and gender groups, the LEI remains a useful tool for quantifying background levels of stress in both workplace stress audits and epidemiological studies where statistical control for non-occupational sources of stress is required.

Adolescent↗
PubMed1997

An international questionnaire to explore neurotoxic symptoms.

EURONEST (European Neurotoxic Solvents Toxicity) is a concerted action within the European Communities to use standardized methods available in all countries. The product of this effort is a new symptom questionnaire, EUROQUEST (European Questionnaire). The original version was developed in English. To obtain transcultural reliability, the translation of questionnaires into other languages must be validated. We adopted a procedure with translation, back translation, and agreement between translators. Ten other European countries also followed the same translation procedure for EUROQUEST.

Hazardous Substances↗
PubMed1997

Non-specific symptoms in response to hazard exposure in the workplace.

Recent concerns in occupational health have shown a shift in emphasis from the study of diseases with well-established pathology toward the investigation of conditions characterized by a range of nonspecific symptoms. Exposure to potential hazards differing widely in terms of their physical nature or chemical composition, for example, electromagnetic fields, organophosphate-based pesticides, and organic solvents, frequently results in the reporting of a relatively consistent group of symptoms. Furthermore, these symptoms may arise among groups of workers where no specific physical or chemical cause can be implicated; for example, in many cases of sick building syndrome. The role of psychosocial factors in the expression of ill-health has been well-documented in the psychological literature. Important modifying factors include the attitudes and belief systems of the individuals concerned, certain personality and behavior patterns, and the presence of current stress or pre-existing psychological distress. In addition, social processes may be involved in the generation and reinforcement of health concerns at the group level. These include the workers' perceptions of the competence and credibility of managers and professionals, and the influence and involvement of the media, pressure groups, and the legal system. A proper understanding of the association between putative hazards and the reporting of nonspecific symptoms therefore requires consideration not only of the direct physical pathway between hazard and harm, but also an assessment of factors which may modify the relationship between exposure and symptom reporting. The results of such investigations have important implications for determining the focus of any management and control strategies which may subsequently be implemented in the workplace.

Attitude to Health↗
PubMed1997

The problems associated with pesticide use by irrigation workers in Ghana.

The use of pesticides in Ghanaian agriculture, though beneficial in reducing crop loss both before and after harvest, has been associated with threats to human health often due to the misapplication of the chemicals. This study was an initial attempt to explore the knowledge, attitudes and practices of 123 farm workers on three irrigation project areas in the Accra Plains, Ghana, regarding the safe handling and use of pesticides, to assess the prevalence of symptoms associated with organophosphorus pesticides (OPs) and carbamates and to determine the prevalence of pesticide-related symptoms, and blood cholinesterase. The study design was cross-sectional in type. Methods used were interviews and observation, and biological monitoring. The results revealed moderate levels of knowledge of the routes of absorption of pesticides and of potential symptoms following exposure. Knowledge of personal protective measures was poor to moderate. High risk practices included frequent handling of the chemicals, home storage of pesticides and short re-entry intervals. Despite knowledge of some health risks associated with pesticides, the use of personal protective equipment (PPE) was minimal due primarily to financial constraints. The prevalence of symptoms was higher and cholinesterase levels lower than in a control group of teachers. It is suggested that there is a need for more epidemiologic studies to investigate the problems associated with pesticide induced ill health as well as research into appropriate and affordable PPE. PPE needs to be subsidized. Training of agriculture and health workers in safety precautions, recognition, and management of pesticide-related ill health is a matter of urgency.

Adult↗
PubMed1997

Health and safety problems associated with long working hours: a review of the current position.

The European Community Directive on Working Time, which should have been implemented in member states of the European Community by November 1996, contains several requirements related to working hours, including the right of employees to refuse to work more than 48 hours a week. The United Kingdom government attempted to oppose the Directive, arguing that there is no convincing evidence that hours of work should be limited on health and safety grounds. Much of the research in this area has focused on the problems of shiftworking and previous reviews have therefore tended to emphasise this aspect of working hours. However, there is much less information about the effects of overtime work, which is a central element of the terms of the Directive. This paper reviews the current evidence relating to the potential effects on health and performance of extensions to the normal working day. Several gaps in the literature are identified. Research to date has been restricted to a limited range of health outcomes--namely, mental health and cardiovascular disorders. Other potential effects which are normally associated with stress--for example, gastrointestinal disorders, musculoskeletal disorders, and problems associated with depression of the immune system, have received little attention. Also, there have been few systematic investigations of performance effects, and little consideration of the implications for occupational exposure limits of extensions to the working day. Existing data relate largely to situations where working hours exceed 50 a week and there is a lack of information on hours below this level, which is of direct relevance to the European Community proposal. Finally, it is clear from investigations relating to shiftwork that a range of modifying factors are likely to influence the level and nature of health and performance outcomes. These include the attitudes and motivation of the people concerned, the job requirements, and other aspects of the organisational and cultural climate. It is concluded that there is currently sufficient evidence to raise concerns about the risks to health and safety of long working hours. However, much more work is required to define the level and nature of those risks.

Adaptation, Psychological↗
PubMed1996

Current approaches to neurobehavioural testing in occupational health.

In recent years neurobehavioural tests have been used increasingly in occupational settings to identify changes in cognitive function associated with exposure to neurotoxicants. Potential applications of these methods in occupational health include research, diagnosis, and screening. Applications in cross sectional research studies, involving the comparison of the performance of exposed and control groups, are well established. However, the use of such methods requires attention to factors other than exposure which may influence test performance. The validity of adapting existing test batteries for diagnosis or screening is questionable. Well developed techniques exist for diagnosis but this requires lengthy and skilled test administration and interpretation and cannot be accomplished with research batteries. The application of neurobehavioural methods for screening currently presents several difficulties. Current problems and future directions in this field are discussed.

Cognition Disorders↗
PubMed1996

Modifiers of non-specific symptoms in occupational and environmental syndromes.

Many occupational and environmental health hazards present as an increased reporting of non-specific symptoms such as headache, backache, eye and respiratory irritation, tiredness, memory problems, and poor concentration. The pattern and number of such symptoms is surprisingly constant from hazard to hazard suggesting that common psychological and social factors, not directly related to the exposure may be involved. A recent workshop (see acknowledgements) was held to review the pattern of symptoms in varying hazardous situations and the psychological mechanisms behind the genesis and maintenance of symptoms. The involvement of both direct physicochemical and psychological mechanisms in symptom generation and reporting in any situation was discussed and is reported here. A model that identifies the issues that need to be considered in any epidemiological study based on the incidence or prevalence of non-specific symptoms is proposed.

Affective Symptoms↗
PubMed1996

Abnormalities on neurological examination among sheep farmers exposed to organophosphorous pesticides.

OBJECTIVES: Organophosphates are effective pesticides which are frequently used in several agricultural settings. Although their acute effects are well characterised, it remains unclear whether long term exposure can damage the human nervous system. This study sought to investigate their long term effects by comparing abnormalities on neurological examination between groups of workers exposed to organophosphates and an unexposed group. METHODS: 146 exposed sheep farmers and 143 unexposed quarry workers were recruited into a cross sectional study of symptoms and neuropsychological effects of long term exposure to organophosphates in sheep dip. From a symptom questionnaire given immediately after dipping the 10 most symptomatic and 10 least symptomatic farmers were selected. Several months later each of these, along with 10 of the unexposed quarry workers, underwent a standardised neurological examination similar to that which might be used in clinical practice, at at time as remote as possible from recent exposure to organophosphates so as to exclude any acute effects. RESULTS: All 30 selected subjects agreed to participate. The components of the examination which showed a significant difference were two point discrimination on the dorsum of the hand (symptomatic farmers 22 mm; asymptomatic farmers 13 mm; quarry workers 8 mm) and the dorsum of the foot (symptomatic farmers 34 mm; asymptomatic farmers 10 mm; quarry workers 11 mm), and mean calf circumference (symptomatic farmers 35.0 cm; asymptomatic farmers 36.3 cm; quarry workers 38.6 cm). Overall the prevalence of neurological abnormalities was low. CONCLUSIONS: The differences in neurological examination detected between groups were subtle and their clinical significance was unclear. However, they do suggest evidence of an adverse neurological effect from exposure to organophosphates. Further, larger scale studies will be required before it is possible to confirm or refute the differences detected.

Adult↗
PubMed1995

Neuropsychological effects of long-term exposure to organophosphates in sheep dip.

Organophosphate-based pesticides are widely used throughout the world. The acute effects of over-exposure to such compounds are well known. Concern has also been expressed that long-term exposure may result in damage to the nervous system. In a cross-sectional study, we compared neuropsychological performance in 146 sheep farmers who were exposed to organophosphates in the course of sheep dipping with 143 non-exposed quarry workers (controls). The farmers performed significantly worse than controls in tests to assess sustained attention and speed of information processing. These effects remained after adjustment for covariates. The farmers also showed greater vulnerability to psychiatric disorder than did the controls as measured by the General Health Questionnaire. There were no observed effects on short-term memory and learning. Repeated exposure to organophosphate-based pesticides appears to be associated with subtle changes in the nervous system. Measures should be taken to reduce exposure to organophosphates as far as possible during agricultural operations.

Adolescent↗
PubMed1995

The use of neurobehavioural test batteries for research, diagnosis and screening: methodological aspects.

In recent years neurobehavioural tests have been used increasingly in occupational and environmental settings to identify changes in cognitive functioning associated with exposure to neurotoxicants. Applications in cross-sectional research studies, involving the comparison of the performance of exposed and control groups, are relatively well established. However, the use of such methods requires attention to a variety of methodological issues including aspects of study design such as sample size, the selection of appropriate controls, the separation of acute and chronic effects and control or adjustment for numerous potential influences on performance. Studies requiring repeated testing, such as longitudinal investigations or studies of acute effects require attention to learning and practice effects and diurnal rhythms. The validity of adapting existing test batteries for use as diagnostic or screening instruments is questionable. Well-developed techniques exist for diagnosis but this requires lengthy and skilled test administration and interpretation and cannot be accomplished using research batteries. Existing tests may, in the future, be used for screening, but a number of problems will need to be addressed before they can be successfully applied in this context.

Animals↗
PubMed1994

Retrospective assessment of solvent exposure in paint manufacturing.

This paper describes how exposure to solvents at two large paint making sites was assessed in a study carried out to investigate the possibility of neuropsychological effects resulting from long term exposure to organic solvents. A job exposure matrix was constructed by buildings and year. A detailed plant history was taken and this was used to identify uniform exposure periods during which workers' exposure to solvents was not thought to have changed significantly. Exposure monitoring data, collected by the company before the study, was then used to characterise exposure within each uniform exposure period. Estimates were made for periods during which no air monitoring was available. Individual detailed job histories were collected for subjects and controls. The job histories were used to estimate exposure on an individual basis with the job exposure matrix. Exposure was expressed as duration, cumulative dose, and intensity of exposure. Classification of exposure by duration alone was found to result in misclassification of subjects.

Environmental Monitoring↗
PubMed1994

Investigation of dose related neurobehavioural effects in paintmakers exposed to low levels of solvents.

A cross sectional study was carried out to compare 110 paintmakers exposed to solvents with 110 age matched controls for outcome measures designed to assess cognitive performance and mental health. Hygiene data available for the paintmakers allowed the development of individual indices of solvent exposure and the analyses of health effects in relation to both duration and intensity of exposure. No effects on cognitive functioning or mental health were found in the paintmakers. For most of their period of employment the exposure of the paintmakers had been below current occupational exposure limits. The results are therefore interpreted as providing support for the view that long term exposure at or below current compliance levels does not result in damage to the central nervous system.

Cognition Disorders↗
PubMed1992

Neurobehavioral effects of long-term occupational exposure to organic solvents: two comparable studies.

Two comparable cross-sectional studies were carried out employing the same methodology but involving two separate solvent-exposed populations (N = 90, N = 144). In each study, solvent-exposed workers were compared with age-matched controls on tests selected from the Neurobehavioral Evaluation System and on standardized questionnaire measures of symptomatology and psychiatric state. A similar pattern of results was obtained in the two studies indicating a significant effect on cognitive functioning, after controlling for confounding variables, occurring in those with more than 30 years of exposure. A more specific effect on learning processes was observed in those with more than 10 years of exposure. There were no indications in either study of a solvent-related increase in psychiatric symptoms.

Adult↗
PubMed1992

Effects of a change in shift work on health.

Aspects of health were studied in a sample of factory workers who changed their pattern of working from 'fortnight about' to three advancing shifts. Within the same factory and doing similar work there was a comparison group who were working permanent days only. The change in shifts was associated with more difficulty with sleep, more indigestion, higher alcohol consumption, reduced alertness and a worse social life. There was more minor psychiatric disturbance in those who worked three shifts than in those who worked days only.

Absenteeism↗
PubMedDate not supplied

Organophosphates: the relationship between chronic and acute exposure effects.

The relationship between chronic (nonreversing) neuropsychological effects and acute exposure effects was investigated in 77 organophosphate exposed male sheep-dippers. Acute exposure effects were assessed prospectively using a purpose-constructed symptoms questionnaire administered pre-, and 24 h postexposure. Urine was analysed for dialkylphosphate levels to confirm recent exposure. Chronic effects were assessed in a cross-sectional neuropsychological study in the absence of recent exposure using computerised neuropsychological tests, the General Health Questionnaire, and the Subjective Memory Questionnaire. Simple correlation and multiple linear regression analyses (adjusting for confounders) were used to assess relationships between the change in total symptom reporting from baseline to 24 h after exposure and chronic effect outcomes. There was no evidence of any association between reported symptom levels and chronic neuropsychological effects. This suggests that chronic effects of OP exposure appear to occur independently of symptoms that might immediately follow acute OP exposure. This has implications for exposure control: individuals may experience chronic effects without the benefit of earlier warning signs of toxic effects during acute exposures.

Acute Disease↗
PubMedDate not supplied

Analysis of chlorpyrifos exposure and human health: expert panel report.

This report summarizes the deliberations of an eight-member panel of scientists convened by Dow AgroSciences in cooperation with the U.S. Environmental Protection Agency (EPA). The panel was charged with evaluating the scientific literature on the health effects potentially associated with exposure to the insecticide chlorpyrifos. Specifically, the panel was asked to (1) evaluate human experience data available and address the adequacy of the available current literature; (2) develop a list of recommendations for epidemiology studies, including appropriate endpoints and study populations, and strengths and weaknesses of each approach; and (3) draft a report to summarize its recommendations. The panel assessed the quality of the existing epidemiologic literature on chlorpyrifos and specific outcomes such as neuropathy (including organophosphate induced delayed neurotoxicity), behavior (cognition and affect), immunologic, and multiple complaints (also referred to as multiple chemical sensitivities). The majority of panel members (five members) agreed that the literature reviewed provided little or no scientific evidence that chlorpyrifos exposure causes harm to human health other than its known cholinergic effects associated with acute poisoning. Those panel members voting in the minority (three members) agreed that the studies reviewed provided inadequate evidence to preclude the possibility of adverse effects to human health from chlorpyrifos exposure at levels associated with its manufacture or professional application. Those voting in the minority suggested further investigation of cohort(s) of workers engaged in either the manufacture or the professional application of chlorpyrifos, or both. Compared to the general population, these groups have relatively high levels of exposure to chlorpyrifos. The primary health outcomes recommended for study were cognitive and affective disorders, with consideration of the assessment of peripheral neuropathy also suggested for at least a subset of the cohort.

Agricultural Workers' Diseases↗